WellCare Specialty Pharmacy, Inc. – Community/Retail Pharmacy, NPI 1073733408

WellCare Specialty Pharmacy, Inc. is a healthcare provider. based in Tampa, Florida. specializing in Community/Retail Pharmacy. The organization holds a License No. PH22669 (FL). The NPI Number for WellCare Specialty Pharmacy, Inc. is 1073733408

Main info

Organization
Name
WellCare Specialty Pharmacy, Inc.
NPI
1073733408
Phone
(866) 458-9246
Address
4110 GEORGE ROAD
Authorized Official
JESSICA DAWN CICCOLELLA-KAHL PRESIDENT
Enumeration Date
26 April 2007
Last Update Date
9 February 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for WellCare Specialty Pharmacy, Inc.

  • 4110 GEORGE ROAD

    SUITE 100

    TAMPA, FL 336347466

    Phone: (866) 458-9246

    Fax: (886) 458-9245

    Type: Mailing

  • 8715 HENDERSON RD

    TAMPA, FL 336341143

    Phone: (866) 458-9246

    Fax: (886) 458-9245

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-09-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-01-31 (128 days ago).

Enrollment records

2

Earliest due date

2026-01-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20160323002671OPharmacyFL2026-01-31
O20220902000880OPharmacyFLTBD

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33634)

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Reviews

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Frequently asked questions

Is there an official ID for WellCare Specialty Pharmacy, Inc. in U.S. healthcare records?
The official identifier for WellCare Specialty Pharmacy, Inc. is NPI 1073733408.
Is WellCare Specialty Pharmacy, Inc. shown as active in public data?
Registry records indicate WellCare Specialty Pharmacy, Inc. maintains an active NPI.
What clinical focus is listed for WellCare Specialty Pharmacy, Inc.?
At a glance, WellCare Specialty Pharmacy, Inc. is tied to Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Is WellCare Specialty Pharmacy, Inc. associated with Tampa?
Public fields place WellCare Specialty Pharmacy, Inc. around Tampa, Florida. Always confirm the exact site before visiting.
Does WellCare Specialty Pharmacy, Inc. accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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